- Humana (Boise, ID)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works… more
- Elevance Health (Meridian, ID)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Trinity Health (Nampa, ID)
- …Type:** Full time **Shift:** Day Shift **Description:** **We are accepting applications for a Nurse Manager to support the Ortho Med/Surg Unit at our Level III ... Nampa, Idaho.** This position reports directly to the Chief Nursing Officer and manages a team on a 36-Bed...include wound care and minor trauma cases. As a Nurse Manager , you will assume direct responsibility… more
- Prime Therapeutics (Boise, ID)
- …+ Clinical and Quality oversight for this program is provided by the Manager , Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years ... post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Magellan Credentialing criteria.… more
- Magellan Health Services (Boise, ID)
- …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided...an active work load in accordance with National Care Manager performance standards. + Works with community agencies as… more
- Trinity Health (Boise, ID)
- …quality of care. **GENERAL SUMMARY AND PURPOSE:** Provides hospital case management / utilization review and discharge planning collaboratively determining level ... care as appropriate. Coordinates the hospital activities concerned with case management / utilization review and discharge planning. Adheres to departmental goals,… more
- HCA Healthcare (Caldwell, ID)
- …experience in case management or 3+ years of experience in clinical nursing required. + American Red Cross or American Heart Association Basic Life Support ... you have the PRN career opportunities as a(an) Case Manager PRN you want with your current employer? We...(BLS or BCLS) and Certification. + Certification in case management or utilization review preferred. + InterQual… more
- St. Luke's Health System (Boise, ID)
- …Blood Management (PBM) program, under the leadership of the PBM Quality RN Manager . Are you an experienced clinical nurse who enjoys science, is data-driven ... then this may be the role for you! St. Luke's Patient Blood Management (PBM) is an interdisciplinary, patient-centered program for optimizing patient Blood Health… more
- HCA Healthcare (Idaho Falls, ID)
- …through administrative and clinical staff including providers, front desk, medical records, nursing , and ancillary services to ensure maximum utilization of ... with East Falls Primary Care, you can be a manager in an organization that is devoted to giving!...Physician Services I provides support to hospital facilities operations management related to physicians, including primary care, specialists, and… more
- Trinity Health (Boise, ID)
- …Institute practices include 100+ staff including cardiologists, surgeons, APPs, Practice Managers, Nursing Manager , Nursing Supervisors, and clinical and ... services, and development of relationships with internal and external customers, financial management and participation in strategic planning. + You will report to… more
- Danaher Corporation (Boise, ID)
- …that includes some of the following: infection detection/control, decision support, utilization management , case management , quality outcome measures, ... pursuit of patient care objectives. Engagement with senior leaders from nursing , emergency medicine, internal medicine, infectious disease, intensive care, pharmacy,… more